Review Practice Exercise 1

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Practice Exercise 1

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Total Questions : 5

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Question 1:

A nurse is caring for a patient with a newly diagnosed brain tumor. The primary reason a brain tumor, whether benign or malignant, causes significant neurological symptoms is due to:

A. The tumor's ability to produce toxins that poison brain cells. B. Its ability to create an inflammatory response throughout the body. C. The compression and infiltration of brain tissue, leading to increased intracranial pressure. D. The breakdown of the blood-brain barrier, allowing harmful substances to enter the brain.

Answer and Explanation

Choice A:

The tumor's ability to produce toxins that poison brain cells: Brain tumors do not release toxins; their effects are due to mechanical compression and infiltration.

Choice B:

Its ability to create an inflammatory response throughout the body: Brain tumors cause local effects in the CNS rather than widespread systemic inflammation.

Choice C:

The compression and infiltration of brain tissue, leading to increased intracranial pressure: This is the primary mechanism for neurological symptoms in brain tumors. Space-occupying effects compromise blood flow, damage neurons, and can result in herniation if untreated.

Choice D:

The breakdown of the blood-brain barrier, allowing harmful substances to enter the brain: While tumors may affect the blood-brain barrier, this is not the primary cause of neurological symptoms.

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Question 2:

A nurse is caring for a client who has a benign brain tumor. The client asks the nurse if he can expect this same type of tumor to occur in other areas of his body. Which of the following is an appropriate response by the nurse?

A. It can spread to breasts and kidneys B. It can develop in your GI tract C. It is limited to brain tissue D. It probably started in another area of your body and spread to your brain

Answer and Explanation

Choice A:

It can spread to breasts and kidneys: Benign tumors do not metastasize to other organs; only malignant tumors have this capability.

Choice B:

It can develop in your GI tract: Tumors in the gastrointestinal tract would be separate conditions and are unrelated to a primary brain tumor.

Choice C:

It is limited to brain tissue: Benign brain tumors do not spread to other organs. They grow locally and only affect surrounding brain structures.

Choice D:

It probably started in another area of your body and spread to your brain: This describes metastatic brain cancer, not a benign primary tumor.

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Question 3:

Which statement correctly differentiates between a primary and a metastatic brain tumor?

A. Primary tumors are more common in adults, while metastatic tumors are more common in children. B. Primary tumors originate from cells within the brain, while metastatic tumors originate elsewhere and spread to the brain. C. Primary tumors are always malignant, and metastatic tumors are always benign. D. Primary tumors are typically easier to treat than metastatic tumors due to their slower growth rate.

Answer and Explanation

Choice A:

Primary tumors are more common in adults, while metastatic tumors are more common in children: The opposite is generally true; metastatic tumors are more common in adults, and some primary brain tumors (like medulloblastoma) are more common in children.

Choice B:

Primary tumors originate from cells within the brain, while metastatic tumors originate elsewhere and spread to the brain: This is the fundamental difference between the two types. It guides diagnostic evaluation and affects the overall treatment approach.

Choice C:

Primary tumors are always malignant, and metastatic tumors are always benign: Both primary and metastatic tumors can be malignant, and benign metastatic tumors do not exist.

Choice D:

Primary tumors are typically easier to treat than metastatic tumors due to their slower growth rate: Treatment difficulty depends on tumor type, location, and accessibility, not simply growth rate.

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Question 4:

A nurse is assessing a patient for signs of increased intracranial pressure (ICP) related to a brain tumor. Which of the following clinical manifestations are classic signs of increased ICP? Select all that apply.

A. Bradycardia B. Projectile vomiting C. Hypertension with widened pulse pressure D. Headache, especially worse in the morning E. Tachycardia

Answer and Explanation

Choice A:

Bradycardia: Part of Cushing’s triad; results from brainstem compression affecting autonomic regulation. Slow heart rate is an early warning of rising ICP.

Choice B:

Projectile vomiting: Caused by direct pressure on the vomiting center in the medulla. It often occurs without nausea and is a classic ICP sign.

Choice C:

Hypertension with widened pulse pressure: Another component of Cushing’s triad. It reflects the body’s attempt to maintain cerebral perfusion despite rising ICP.

Choice D:

Headache, especially worse in the morning: Results from nocturnal hypoventilation and increased CO₂, which raises ICP when the patient is supine. Morning headaches are a common early symptom of brain tumors.

Choice E:

Tachycardia: This is not a classic sign of ICP and usually occurs in response to hypovolemia, fever, or pain. Increased ICP typically causes bradycardia instead.

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Question 5:

Which of the following describes a meningioma?

A. A highly malignant tumor that originates from astrocytes. B. A benign tumor arising from the meninges that surround the brain. C. A tumor of the pituitary gland that always causes hormone-related symptoms. D. A tumor of the cranial nerve VIII, responsible for hearing.

Answer and Explanation

Choice A:

A highly malignant tumor that originates from astrocytes: This describes glioblastoma multiforme, not meningioma.

Choice B:

A benign tumor arising from the meninges that surround the brain: This is the defining feature of meningiomas. Their symptoms result from pressure effects rather than infiltration of brain tissue.

Choice C:

A tumor of the pituitary gland that always causes hormone-related symptoms: Pituitary adenomas may or may not produce hormones and are not meningiomas.

Choice D:

A tumor of the cranial nerve VIII, responsible for hearing: This describes a vestibular schwannoma (acoustic neuroma), not a meningioma.

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Practice Exercise 1

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